The Christian Science Monitor on Monday examined the challenges of updating the veterans' health care and disability systems as more injured servicemembers are returning from Iraq and Afghanistan. President Bush last week announced a plan to streamline the disability system between the departments of Veterans Affairs and Defense. His proposal is based on recommendations from a presidential commission headed by former Sen. Bob Dole (R-Kan.) and University of Miami President and former HHS Secretary Donna Shalala.

Meanwhile, the Government Accountability Office last week released a report saying that services for wounded veterans exhibit "fundamental system weaknesses." According to the Monitor, the number of soldiers killed in the wars in Iraq and Afghanistan is a "relatively smaller portion of overall casualties," resulting in the increased need for care, especially in medical specialties.

American Legion's Joseph Wilson, who recently testified before Congress, said national staffing shortages could reach 24,000 physicians and almost one million nurses by 2020. He added, "Another challenge (is) acquiring staff trained in certain specialty fields," such as "physical medicine and rehabilitation, blind rehabilitation, speech and language pathology, physical therapy and certified rehabilitation nursing."

Linda Bilmes, a professor at the Kennedy School of Government at Harvard University, estimates that long-term costs of disability benefits and medical services could reach $700 billion for Iraq and Afghanistan war veterans. She said, "The cost of providing such care and paying disability compensation is a significant long-term entitlement cost that the U.S. will be paying for the next 40 years" (Knickerbocker, Christian Science Monitor, 10/22).

"Despite promises for reform" in services for wounded veterans, "the fixes have been, as one congressman observed, 'frustratingly slow' in coming," the Washington Post writes in an editorial. "The prospects for streamlining the system are uncertain," the Post continues, adding, "Already, some veteran groups are wary of change, especially if, as proposed, it affects only veterans who entered the military after October 2001."

The editorial says that Bush "should press Congress for quick action," concluding, "He can set the example by moving to implement the recommendations from the Dole-Shalala commission that don't require legislation. The courageous men and women who didn't hesitate in serving their country should wait no longer" (Washington Post, 10/21).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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